Child survival on fast track, but we need to do more: Azad

Interventions under the National Rural Health Mission, such as mother and child tracking system, improved immunisation, focus on 200 underdeveloped districts with poor health indices and focus on net intuitional deliveries has lead to a sharp reduction in newborn and under-five deaths in India, said Union health minister Ghulam Nabi Azad in Mammallapuram on Thursday.

"Improved tracking and a sharp surge in in institutional deliveries in the past few years -- we've set up 415 delivery centres, adding 25,000 this year alone -- has led to a quantum jump in the annual rate of decline of newborn and child death in rural areas in the past two years," said Azad

He was speaking at the Call to Action Summit on Child Survival and Development.

"As a result, India's decline in Under-five mortality rate has accelerated to an average of 7.5% each year. Even though the average Under five child mortality rate has always been lower in urban areas, the rate of decline in rural areas has been much faster," said Anuradha Gupta, additional secretary and mission director, National Rural Health Mission.

Though India's the rate of decline in U5MR has been much faster than the global average: from 115 in 1990 to 59 in 2010 as against the global average of 87 and 57 respectively, it has not been fast enough to save more than a million children from avoidable death.

Nearly 1.5 million children die before their fifth birthday each year in India, with close to 0.8 million deaths taking place within 28 days of birth. This puts India among the top five countries -- Nigeria, Congo, Pakistan and China being the other four -- that account for half of the world's under-five deaths.

One reason, of course, is the sheer number of children being born each year -- more than 26 million. Another 158 million children are under-5 years, many of whom are at risk of frequent infections because of poor sanitation and undernourishment.

"High focus is being given to high-impact interventions that have been shown to save most lives -- special supportive care of newborns and preterm, small and sick babies (saves 179,000 lives a year), skilled care in labour and delivery, pneumonia management, immunisation, (particularly measles and tetanus toxoid), exclusive breast-feeding, diarrhoea management and giving iron and folic acid supplementation to adolescents and pregnant and lactating women," said Gupta.

Reductions in Under-5 deaths vary widely across states and even within districts in the states, with some, like Tamil Nadu, showing a 12.5% drop in newborn and child deaths.

"Globally, childhood pneumonia, complications of preterm births and diarrhoea are the leading cause of newborn and child deaths, with 50% reductions in child deaths since 1990 coming from preventing and treating childhood pneumonia, diarrhoea and measles," said Nancy J Powell, US ambassador to India.

The Global Call to Action for Child Survival challenges countries to lower their national rates of child mortality to 20 or fewer deaths per 1,000 live births by 2035.

India's Summit on Child Survival and Development is supported by Unicef and USAID.